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Molekulare Ultraschallbildgebung

Chancen für die Klinik

Molecular ultrasound imaging

Clinical applications

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Zusammenfassung

Hintergrund

Die Ultraschallbildgebung mit Kontrastmitteln wird klinisch zunehmend angewendet, v. a. für kardiovaskuläre Fragestellungen und für die Leberdiagnostik. Die Verfügbarkeit molekularer Kontrastmittel und deren beginnende klinische Translation versprechen derzeit neue Möglichkeiten für eine pathomechanistische Diagnostik.

Material und Methoden

Auswertung aktueller Literatur zur Entwicklung molekularer Ultraschallkontrastmittel, von deren Detektionsmethoden und von ihrem Einsatz in präklinischen und klinischen Studien.

Ergebnisse

In der präklinischen Forschung haben sich molekulare Ultraschallkontrastmittel zur Detektion von Inflammation und Angiogenese in den letzten Jahren etabliert und werden kontinuierlich weiterentwickelt. Sie bestehen aus 1–5 µm großen, gasgefüllten Mikrobläschen, deren Gaskern mit einer Hülle aus Lipiden, Proteinen oder Polymeren stabilisiert ist und an die Biomoleküle konjugiert sind, welche die Targetspezifität determinieren. BR55 ist das erste klinisch erprobte Ultraschallkontrastmittel. Es bindet an den Angiogenesemarker Vascular Endothelial Growth Factor Receptor 2 (VEGFR2, Kinase-insert Domain Receptor [KDR]) und wurde in unterschiedlichen präklinischen und klinischen Studien der Phase I und II zur Tumordiagnostik eingesetzt.

Schlussfolgerung

Die molekulare Ultraschallbildgebung zeigt im präklinischen Bereich große Fortschritte und ein breites Anwendungsgebiet. Eine Translation in klinische Anwendungen ist für verschiedene Indikationen vorstellbar und wird mit BR55 derzeit umgesetzt.

Abstract

Background

Contrast-enhanced ultrasound imaging is increasingly being used in clinical applications, particularly for cardiovascular and liver diagnostics. In this context the availability of new molecular contrast agents and the initiation of clinical translation promises new options for pathomechanistic diagnostics.

Material and methods

Analysis of the current literature on the development of molecular ultrasound contrast agents, the detection methods as well as the applications in preclinical and clinical studies.

Results

Molecular contrast agents have become established in preclinical research for the detection of inflammation and angiogenesis and have been continuously refined over recent years. They consist of gas filled microbubbles with a diameter of 1–5 µm and the gas core is stabilized by a shell made of lipids, proteins or polymers to which biomolecules are conjugated that determine the target specificity. The agent BR55 is the first clinically evaluated molecular ultrasound contrast agent. It binds to the angiogenesis marker vascular endothelial growth factor receptor 2 (VEGFR2) and has been studied in several preclinical and clinical phase I and II studies on tumor diagnostics and characterization.

Conclusion

Molecular ultrasound imaging is rapidly evolving in preclinical research for a broad field of applications. Translation to clinical practice is conceivable for many indications and is already ongoing for BR55.

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Authors and Affiliations

  1. Institut für Experimentelle Molekulare Bildgebung, Pauwelsstrasse 30, 52074, Aachen, Deutschland

    A. Rix,  M. Palmowski &  F. Kiessling

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  1. A. Rix
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  2. M. Palmowski
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  3. F. Kiessling
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Corresponding author

Correspondence to F. Kiessling.

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Interessenkonflikt

A. Rix, M. Palmowski und F. Kiessling geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Rix, A., Palmowski, M. & Kiessling, F. Molekulare Ultraschallbildgebung. Radiologe 55, 956–963 (2015). https://doi.org/10.1007/s00117-015-0023-4

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